Drug Detail:Nexterone (Amiodarone (injection) [ a-mi-oh-da-rone ])
Generic Name: AMIODARONE HYDROCHLORIDE 1.5mg in 1mL
Dosage Form: injection, solution
Drug Class: Group III antiarrhythmics
General Considerations
Inspect parenteral drug products for particulate matter and discoloration prior to administration, whenever solution and container permit, solution should be clear. Visually inspect the container. If the administration port protector is damaged, detached or not present, discard the container as the solution path sterility may be compromised. Check for minute leaks prior to use by squeezing the bag firmly. If leaks are detected, discard solution as sterility may be impaired. Protect from light until ready to use.
NEXTERONE Premixed Injection is available in GALAXY containers as a single-use, ready-to-use, iso-osmotic solution in dextrose for intravenous administration. No further dilution is required. Discard any unused portion after use.
Administer NEXTERONE, whenever possible, through a central venous catheter dedicated to that purpose. Use an in-line filter during administration.
Recommended Dosage
NEXTERONE response can vary. Monitor patient response and adjust dose accordingly. In controlled clinical trials, mean daily doses above 2100 mg were associated with an increased risk of hypotension.
Loading Infusion |
First Rapid |
150 mg over the FIRST 10 minutes (15 mg/min). Directly infuse NEXTERONE Premixed Injection (150 mg/100 mL; 1.5 mg/mL) at a rate of 10 mL/min. |
Followed by |
360 mg over the NEXT 6 hours (1 mg/min). Directly infuse NEXTERONE Premixed Injection (360 mg/200 mL; 1.8 mg/mL) at a rate of 0.556 mL/min. 540 mg over the REMAINING 18 hours (0.5 mg/min) Decrease the rate to 0.278 mL/min. |
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After the first 24 hours, continue the maintenance infusion 720 mg per 24 hour period (0.5 mg/min) Directly infuse NEXTERONE Premixed Injection (360 mg/200 mL; 1.8 mg/mL) at a rate of 0.278 mL/min). |
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Breakthrough VF or |
150 mg supplemental infusion over 10 minutes (15 mg/min). Directly infuse NEXTERONE Premixed Injection (150 mg/100mL; 1.5 mg/mL) at a rate of 10 mL/min. |
Admixture Incompatibility
Amiodarone in D5W Injection forms precipitates with the drugs shown in Table 2. If co-administration of the following drugs is necessary, use separate intravenous administration lines.
D5W = Dextrose 5% in Sterile Water, NS = Normal Saline | |||||
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Amiodarone |
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Aminophylline |
D5W; NS |
4 mg/mL |
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Amoxicillin Sodium-Clavulanic Acid |
unknown |
12.5 mg/mL |
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Ampicillin Sodium-Sulbactam Sodium |
NS |
6 mg/mL |
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Argatroban |
D5W |
1.8 mg/mL |
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Bivalirudin |
D5W |
4 mg/mL |
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Cefamandole Nafate |
D5W |
4 mg/mL |
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Cefazolin Sodium |
D5W |
4 mg/mL |
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Ceftazidime |
D5W |
6 mg/mL |
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Digoxin |
D5W |
6 mg/mL |
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Furosemide |
D5W |
6 mg/mL |
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Mezlocillin Sodium |
D5W |
4 mg/mL |
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Heparin Sodium |
D5W |
-- |
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Imipenem-Cilastin Sodium |
D5W |
6 mg/mL |
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Magnesium Sulfate (500 mg/mL) |
D5W |
6 mg/mL |
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Micafungin |
NS |
4 mg/mL |
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Piperacillin Sodium –Tazobactam Sodium |
D5W |
6 mg/mL |
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Potassium Phosphates |
D5W |
6 mg/mL |
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Sodium Bicarbonate |
D5W |
3 mg/mL |
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Sodium Nitroprusside |
D5W |
1.5, 6 and 15 mg/mL |
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Sodium Phosphates |
D5W |
6 mg/mL |
Transition From Intravenous Amiodarone to Oral Amiodarone
Table 3 provides suggested doses of oral amiodarone to be initiated after varying durations of NEXTERONE infusion.
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Duration of Amiodarone Infusion* |
Initial Daily Dose of Oral Amiodarone |
Less than 1 week |
800 to 1600 mg |
1 to 3 weeks |
600 to 800 mg |
More than 3 weeks† |
400 mg |